Healthcare Provider Details

I. General information

NPI: 1033445945
Provider Name (Legal Business Name): DANIEL SUZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 ORLEANS ST CRB1, RM 186
BALTIMORE MD
21287-0013
US

IV. Provider business mailing address

1650 ORLEANS ST CRB1, RM 186
BALTIMORE MD
21287-0013
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8893
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD0073867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: